REDUCTION OF LUNG DUST BURDEN IN PNEUMOCONIOSIS BY WHOLE-LUNG LAVAGE

Pneumoconioses are characterized as irreversible, progressive respirat ory diseases. No effective therapy exists to prevent progression of th ese diseases. Whole-lung lavage (WLL) might limit the rate of disease progression through the removal of dust, inflammatory cells, and cytok ines. We performed WLL on a 54-year-old underground miner employed as a motorman and roof bolter and a 55-year-old driller at a surface coal mine. Both demonstrated normal lung function and chest radiographs sh owing ILO profusion category 2 nodular interstitial changes. From Subj ect 1, we recovered 5.24 x 10(8) cells (90% macrophages) from the righ t lung and 3.45 x 10(8) cells (94% macrophages) from the left lung. WL L removed 1.82 g of mineral dust (non-coal) on the right and 1.64 g on the left. From Subject 2, we recovered 7.49 x 10(8) cells (46% macrop hages) from the right and 9.78 x 10(8) cells (69% macrophages) from th e left lung. WLL removed 0.40 g of mineral dust on the right and 0.53 g on the left. Proinflammatory cytokines, growth factors, and cellular enzymes were also recovered. In cases of pneumoconiosis, WLL is capab le of removing relatively large quantities of dust, cells, and soluble materials from the lungs. Only long-term follow-ups of Individuals wi th Progressive dust-induced disease who receive WLL therapy in the con text of a clinical trial will Provide information regarding the import ance of removing mineral dust and inflammatory cells from the lung.